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Copyright of Traditional Chinese Drug Research & Clinical Pharmacology is the property of Traditional Chinese Drug Research & Clinical Pharmacology Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

As the primary place of treatment for mild cognitive impairment (MCI), community primary medical institutions need to carry out cognitive function health management for the MCI population. At present, the community still lacks the specific process and program of MCI cognitive function health management. Based on the "Structure-Process-Results" three-dimensional quality structure theoretical model, this study reviewed the community MCI cognitive function health management strategies from three dimensions of functional departments and organizational structure (Structure), health management program (Process) and effect evaluation system and methods (Results), aiming to provide support and reference for the standardized and process-oriented MCI cognitive function health management practice in Chinese communities.

BACKGROUND: Gait is one of the optimal indicators of functional status in older adults. Gait parameters are associated with adverse health outcomes in older adults. OBJECTIVE: To summarize and compare the practical value of gait parameters, and to review the progress of research on spatio-temporal parameters and the risk of adverse health outcomes in older adults. METHODS: PubMed, Web of Science, and CNKI were searched for relevant literature published from January 2010 to June 2023 using the search terms of “gait speed, walking speed, step length, cadence, step frequency, step time, walking base, aged and elderly” in English and Chinese, respectively. A total of 52 papers were finally included for the systematic review. RESULTS AND CONCLUSION: Currently, researchers have focused on three basic temporal-spatial parameters, namely, step speed, step length and step frequency, to explore their association with adverse health outcomes in older adults. Reduced gait speed in older adults may increase the risk of falls, all-cause mortality, and may be an independent predictor of all-cause mortality. Older adults with slow gait speed are at higher risk of cognitive decline, and may be the preferred gait parameter in assessing cognitive impairment in older adults. Older adults with slow gait speed are more likely to have debilitating or common chronic illnesses, and are at higher risk of hospitalization and public care. Step length is positively correlated with individual height and lower limb length, but age-induced shortening of step length is not related to height or lower limb length, and shortening of step length reflects reduced physical function in older adults, and shortening of step length is a risk factor for falls and cognitive decline in older adults. Stride frequency is often used as a measure of exercise intensity, and a stride frequency of ≥ 100 steps/minute is predictive of all-cause mortality, and slowing of step frequency may lead to a higher risk of falls, hospitalization and all-cause mortality in older adults. Changes in gait parameters are closely related to the level of physical fitness in older adults, and there may be a bidirectional relationship between the two. The results of the study will provide a theoretical basis for further improving risk screening in clinical populations, refining health risk assessment in the elderly, improving health protection and promoting active health in the elderly. [ABSTRACT FROM AUTHOR]

目的 为缺血性脑白质病变（ischemic white matter lesion，IWML）患者认知障碍进展的评估提供影像依据。 方法 回顾性纳入2018年1月—2021年12月就诊于首都医科大学附属北京天坛医院的IWML患者，按照认知功能测评结果分为：非痴呆血管性认知障碍（non-dementia vascular cognitive impairment，VCIND）组、血管性痴呆（vascular dementia，VaD）组。同期入组认知功能和头颅MRI检查正常的就诊患者为正常对照（normal control，NC）组。所有患者均完善了静息态功能MRI检查及注意功能检查，包括Stroop色-词干扰测试B（Stroop color-word interference B test，Stroop B），Stroop色-词干扰测试C（Stroop color-word interference C test，Stroop C），数字连线测验A（trail making test A，TMT-A）和符号数字转换测试（symbol digit modalities test，SDMT）。使用独立成分分析选择左侧和右侧额顶叶网络、初级和次级视觉网络、背侧注意网络5个脑区，选择9个主要区域为感兴趣区，提取每个脑区Z值，作为脑区两两间的功能连接（functional connectivity，FC）值。进行VCIND、VaD和NC组FC差异分析，并进一步分析VCIND、VaD两组脑区间FC变化与注意功能评分的相关性。 结果 共纳入60例患者，其中男性29例（48.3%）。NC组24例，VCIND组19例，VaD组17例。结果提示，与NC组相比，VCIND组完成Stroop B（P＜0.01）、TMT-A（P=0.01）评分更高，SDMT评分更低（P=0.01）；VaD组完成Stroop B、Stroop C及TMT-A评分更高（均P＜0.01），SDMT评分更低（P＜0.01）。与VCIND组相比，VaD组完成Stroop B（P＜0.01）、Stroop C（P＜0.01）及TMT-A（P=0.01）评分更高，SDMT评分（P＜0.01）更低。FC分析显示，与NC组相比，VCIND组右侧背外侧前额叶皮质和左侧顶上小叶（P=0.01）、右侧背外侧前额叶皮质和楔叶（P=0.04）之间的FC值增高；与VCIND组相比，VaD组右侧背外侧前额叶皮质与楔叶（P=0.02）之间的FC值增高。右侧背外侧前额叶皮质和左侧顶上小叶之间的FC值与Stroop C用时呈负相关（r=－0.365，P=0.04），其余脑区之间的FC值与其他注意功能评分项目无显著相关性。 结论 随着认知功能下降，IWML患者执行网络与背侧注意网络、初级视觉网络间的FC值升高，部分脑区间FC的改变伴随着更差的注意功能。 Abstract: Objective To provide an imaging reference for assessing cognitive dysfunction progression in patients with ischemic white matter lesion (IWML). Methods Patients with IWML admitted to Beijing Tiantan Hospital, Capital Medical University from January 2018 to December 2021 were retrospectively included. They were divided into two groups according to the results of the cognitive function assessment: the non-dementia vascular cognitive impairment (VCIND) group and the vascular dementia (VaD) group. Patients with normal cognitive function and brain MRI results were enrolled in the normal control (NC) group at the same time. All patients underwent resting state functional MRI examination and attention function tests, including Stroop color-word interference B test (Stroop B), Stroop color-word interference C test (Stroop C), trail making test A (TMT-A), and symbol digit modalities test (SDMT). The left frontoparietal network, right frontoparietal network, primary visual network, secondary visual network, and dorsal attention network were selected by independent component analysis. Nine major regions were chosen as regions of interest, and the Z value of each brain region was extracted as the functional connectivity (FC) value of the pairwise brain interval. The differences in FC among the three groups were analyzed, and the correlation between altered FC and attention function scores in VCIND and VaD groups was further investigated. Results Among 60 eligible patients, 29 (48.3%) being male. There were 24 cases in the NC group, 19 cases in the VCIND group, and 17 cases in the VaD group. The results suggested that compared with the NC group, the VCIND group had higher scores on the Stroop B (P

交叉性小脑神经机能联系不能（crossed cerebellar diaschisis，CCD）是指当一侧大脑半球发生病变时，病灶对侧小脑半球出现血流量减少、葡萄糖氧化代谢水平下降的功能障碍，严重时甚至可能出现交叉性小脑萎缩的现象。CCD在临床工作中易被忽略或误诊。本文报告1例因左侧幕上脑梗死出现CCD导致左侧肢体共济失调以及认知功能障碍加重的病例，通过文献综述，阐明CCD的发生机制、临床特点及影响因素，为临床提供借鉴。 Abstract: The crossed cerebellar diaschisis (CCD) is a condition characterised by reduced blood flow and decreased oxidative metabolism of glucose in the contralateral cerebellar hemisphere following a lesion in one cerebral hemisphere, potentially resulting in crossed cerebellar atrophy in severe cases. It is easy to be overlooked or misdiagnosed in clinical practice. This paper presents a case of ataxia on the left side and worsening cognitive dysfunction resulting from left supratentorial cerebral infarction-induced CCD. The pathogenesis, clinical characteristics, and influencing factors of CCD were elucidated through the literature review to provide references for clinical practice.

Background Type 2 diabetes mellitus (T2DM) and mild cognitive impairment (MCI) are common health problems in the elderly in the community. Research on the status and influencing factors of MCI in the elderly with T2DM who participate in community management is needed. Objective To explore the cognitive characteristics and related factors of elderly patients with T2DM complicated with MCI under community management. Methods From July to October 2022, a total of 399 patients with type 2 diabetes over 60 years of age in a community health service center in Shanghai were selected by systematic sampling method. General demographic data and health problems, physical examination and laboratory test results, including fasting blood glucose (FBG), total triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA1c) were collected. They were divided into MCI group (n=157) and non-MCI group (n=242) according to the presence or absence of MCI. Binary Logistic regression analysis was used to explore the influencing factors of MCI in elderly patients with type 2 diabetes under community management. Results The prevalence of MCI was 39.3% (157/399) in community-managed elderly patients with type 2 diabetes. The comparison of cognitive characteristics between MCI group and non-MCI group showed that the MCI group had higher abnormality rates in executive function, orientation, calculation, abstraction, delayed memory, visual perception, naming and attention than the non-MCI group, and the differences were statistically significant (P9% (OR=5.106, 95%CI=2.150-12.130), LDL-C (OR=2.451, 95%CI=1.266-4.743), 7-12 years of education (OR=0.419, 95%CI=0.183-0.960) and >12 years (OR=0.243, 95%CI=0.086-0.692) was the influencing factor for MCI in elderly patients with type 2 diabetes (P9% and high level of LDC. High level of education is a protective factor for MCI in community-managed elderly patients with type 2 diabetes. Early cognitive impairment screening, long-term blood glucose control, and lowering LDL-C levels are helpful to improve the cognitive function of community-managed elderly patients with type 2 diabetes.

Background Under the background of an aging population, maintaining brain health has become an inevitable requirement of building a healthy China, and it is of great significance to carry out research on community populations' perceptions of cognitive impairment diseases. However, there is no suitable tools for investigating community populations' perceptions level of Mild Cognitive Impairment (MCI) . Objective To develop a questionnaire on perceptions toward MCI and test its reliability and validity, so as to provide a basis for promoting the management of cognitive disorders. Methods On the basis of literature review and special group discussion, the theoretical framework of questionnaire was put forward and the items of the questionnaire were preliminarily worked out. Then the items were evaluated according to the results of two rounds of mail-based Delphi surveys conducted by 13 experts in related fields in April-May 2021. The description of the items was revised through pre-survey, and the items were analyzed through questionnaire survey by difficulty index analysis, discrimination analysis, correlation coefficient analysis, reliability and validity evaluation in October-December 2021, so as to further improve the questionnaire. Results (1) Delphi survey: The positive degree of experts in the two rounds of Delphi survey was 100.0% and 84.6%, and the expert authority coefficient were 0.858 and 0.845, respectively. The range of "importance" average score of each item in the two rounds of letter inquiry was 3.77-4.92 and 3.91-4.91, and the coefficient of variation of the two rounds was 0.056-0.246 and 0.061-0.213, respectively. The harmony coefficients of Kendall in the two rounds of consultation were 0.197 and 0.252, respectively (P

Objective To explore the hub genes and the potential targets in the treatment of diabetes with TREM2 mutation-related cognitive dysfunction with bioinformatics analysis. Methods The cases of differential genes (DEGs) of diabetes mellitus and TREM2 mutation-related cognitive dysfunction were obtained respectively by microarray data analysis, the common differential genes were obtained by intersection between the two diseases. GO analysis, KEGG and Reactome pathway analysis were performed on the selected differential genes. The protein-protein interaction(PPI) network was constructed using online database. Finally, the effects of diabetes and TREM2 on spatial learning and memory of mice were detected by water maze, and the expression of hub gene SNAP25 was detected by Western blot. Results In both datasets, 19 genes showed similar changes, mainly enriched in biological processes and pathways related to neurons and metabolism. According to PPI analysis, DNER, GFAP, GRM5 and SNAP25 were identified as hub genes. Trem2 gene knockout aggravated spatial learning and memory impairment in diabetic mice. The expression of SNAP25 in hippocampus of diabetes mice was significantly increased, and then decreased after Trem2 knockout. Conclusions This study identified 19 TREM2-related genes in diabetes with cognitive dysfunction, among which 4 hub genes were found. These results provide a new experimental basis for the treatment of diabetes patients with cognitive impairment.

Background Management of mild cognitive impairment (MCI) can reduce the burden of disease on society, families and individuals. The performance of family doctor team is the key to the quality of service, which acts as the main force of chronic disease management in China. Objective To explore the factors influencing the performance of family doctor teams in providing chronic disease management service for patients with MCI. Methods In July 2021, a total of 28 medical workers from 8 community health service centers in 4 districts of Shanghai were selected by purposive sampling method to conduct semi-structured interviews, the interview data were coded and analyzed after the interviews. Results After three levels of coding, 114 concepts, 49 categories and 8 main categories were sorted out, 4 core categories of factors influencing performance were concluded of service organizer (government), service provider (doctor), service demander (patient) and task implementation. The theoretical framework was organized into five main processes, including organizers driving both provider and demander, provider taking the initiative to implement, demander cooperating with implementation, interaction between provider and demander, task execution cycle improvement. Conclusion Although performance of family doctor teams in providing chronic disease management service for patients with MCI is affected by many factors, the process and results are the key to test performance. The driving role of the organizer, execution function of the provider and cooperation of demander are the premise for execution process and result. However, the feedback effect of task execution can improve the quality of service, and eventually form a circular optimization mechanism from organizer drive, to provider execution and demander cooperation, to task execution feedback.

Cognitive dysfunction is one of the serious complications of type 2 diabetes. Exercise intervention has a certain effect on improving diabetes cognition, but the exact process remains ambiguous.This research aims to explore the impact and molecular processes of treadmill exercises in enhancing cognitive impairments in type 2 diabetic mice. Ten m/m 8-week-old male mice were used as the control group. Forty db/db mice, each 8 weeks old and male, were categorized into four distinct groups with each group containing 10 mice, including the db/db group (model group), db+Exe group (exercise group), db+Exe+SB203580 group (exercise combined with the p38 MAPK inhibitor group), db+SB203580 group (p38 MAPK inhibitor group). db+Exe group and db+Exe+SB203580 group were subjected to treadmill running intervention (40min/time, 5 times / week, a total of 8 weeks). db+Exe+SB203580 and db+SB203580 group were intraperitoneally injected with SB203580 (5 mg/kg, 5 times/week, 8 weeks) 2 hours before treadmill exercise. The results of body weights and fasting blood glucose measurement showed that 8-week treadmill exercise could significantly reduce the body mass and fasting blood glucose levels (P<0.01); the results of water maze showed that treadmill exercise improved cognitive dysfunction in diabetic mice (P<0.05). Immunofluorescence staining revealed that treadmill exercise diminished the fluorescence intensity of NLRP3 in hippocampus, and there was a significant difference in CA1 and CA3 regions (P<0.05). Treadmill exercise reduced the fluorescence intensity of PI in the hippocampus, and there was a significant difference in the DG region (P<0.01). The results of qRT-PCR revealed that treadmill exercise decreased IL-1β and IL-18 mRNA levels in hippocampus, with a notable difference in IL-1β mRNA levels(P<0.05). Western blotting analysis revealed that treadmill exercise reduced the concentrations of Caspase3, Caspase9 and Bax in hippocampus (P<0.01), reduced the concentrations of TXNIP, NLRP3, GSDMD-N, IL-1β, IL-18, Cleaved Caspase1 and Caspase1 (P<0.05), decreased the levels of p-RIPK1, RIPK1, p-RIPK3 and RIPK3 (P<0.05). After adding p38 inhibitors, treadmill exercise combined with p38 inhibitor intervention further inhibited the expression of Caspase3, TXNIP, GSDMD-N and IL-18 (P<0.05), and the expression levels of Caspase9, Bax, NLRP3, IL-1β, Cleaved Caspase 1 and Caspase 1 also showed a downward trend. The expression of RIPK1 and p-RIPK3 increased significantly (P<0.05), and the protein expression levels of p-p38, p-RIPK1 and RIPK3 showed an upward trend. In conclusion, treadmill running intervention can effectively improve the cognitive dysfunction in type 2 diabetic mice, and its mechanism is partly through the p38 MAPK signaling pathway to regulate PANoptosis. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the relationship between cognitive impairment and sleep parameters in acute ischemic stroke patients with obstructive sleep apnea (OSA). Methods A total of 343 patients with acute ischemic stroke and OSA were selected. The cognitive function was assessed using the simple mental state examination scale (MMSE). Patients were divided into the stroke with OSA and cognitive impairment group (MMSE＜27 points, n=119) and the stroke with OSA without cognitive impairment group (MMSE≥27 points, n=224). General data, TOAST etiological classification and distribution of cerebral infarction lesions were collected. The intelligent sleep monitoring system was used to calculate apnea hypopnea index (AHI) and evaluate OSA. Objective sleep monitoring parameters were collected at night. Sleep monitoring was conducted within 24 h of admission and continuous monitoring for≥3 nights. Continuous monitoring duration ≥7 h every night to obtain night sleep structure parameters. Multifactor Logistics regression was used to analyze the relationship between cognitive impairment and sleep parameters in stroke patients with OSA. Results Compared with the stroke with OSA without cognitive impairment group, the proportion of age, diabetes history and HHcy history, the proportion of patients with infarct lesions located in frontal, temporal, parietal, occipital, thalamus, basal ganglia, brainstem and hemioval center increased in the stroke with OSA and cognitive impairment group, and the number of years of education decreased, the number of waking times, the proportion of light sleep and AHI increased, the nighttime sleep efficiency and deep sleep period decreased (P＜0.05). Logistics regression analysis showed that after controlling for years of education, age and other interference factors, nighttime sleep efficiency and AHI were strongly associated with cognitive impairment in acute ischemic stroke patients with OSA (P＜0.05). The increased nighttime sleep efficiency was protective factor for cognitive impairment, and increased AHI was risk factor for cognitive impairment. Conclusion Cognitive impairment in acute ischemic stroke patients with OSA is closely related to sleep parameters, in which the increased sleep efficiency at night is a protective factor for cognitive impairment, and the increased AHI is a risk factor. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To establish an in vitro model of neural stem cell (NSC) injury in the mouse hippocampal dentate gyrus area induced by high-fat high-sugar conditions, mimicking diabetic neuropathy, and to explore the role of CDC42 in high-fat high-sugar-related NSC injury. Methods NSCs from embryonic mice were cultured, and their stemness and purity were confirmed by immunofluorescence staining for Sox2 and Nestin. NSCs were cultured with different concentrations of glucose and oxidized low-density lipoprotein (ox-LDL) alone or in combination, and cell viability was assessed using the CCK8 assay to determine suitable glucose and lipid concentrations affecting NSC proliferation. NSCs were then cultured in high-fat high-sugar conditions (HHM) or regular medium (RM）, and their effects on NSC proliferation were assessed by CCK8 assay, scratch assay, and Transwell migration assay. Protein extracts from the hippocampal tissues of 10-week-old db/db mice and NSCs cultured under different conditions were subjected to Western blot analysis to detect CDC42 expression. The specific CDC42 inhibitor ZCL278 (10 μmol/L) was used in vitro to assess its therapeutic effect on high-fat high-sugar-induced NSC proliferation impairment. Results Glucose concentrations of 10-40 mmol/L and ox-LDL concentrations of 25-35 μg/mL inhibited the proliferation of cultured NSCs. A combination of 10 mmol/L glucose and 25 μmol/L oxLDL was selected as the model of HHM-induced NSC injury, which continuously inhibited NSC proliferation within 72 h. Scratch and Transwell migration assays showed that this combination significantly inhibited NSC migration. Increased expression of CDC42 was observed in the hippocampus and NSCs of diabetic mice. In vitro treatment with the CDC42-specific inhibitor ZCL278 increased the viability of NSCs cultured under HHM conditions, suggesting partial reversal of HHM-induced NSC proliferation impairment. Conclusion A combination of 10 mmol/L glucose and 25 mmol/L ox-LDL can simulate glycolipid injury of neural stem cells in diabetic animals, affecting NSC proliferation and migration. Overexpression of CDC42 is involved in high-fat high-sugar-induced inhibition of NSC proliferation. The CDC42-specific inhibitor ZCL278 can partially reverse high-fat high-sugar-induced NSC proliferation impairment. These results provide an in vitro model for studying NSC proliferation and migration impairments associated with abnormal glycolipid metabolism, and suggest that the CDC42-specific inhibitor ZCL278 may partially reverse high-fat high-sugar-related NSC proliferation impairment. [ABSTRACT FROM AUTHOR]

Objective To explore the hub genes and the potential targets in the treatment of diabetes with TREM2 mutation-related cognitive dysfunction with bioinformatics analysis. Methods The cases of differential genes (DEGs) of diabetes mellitus and TREM2 mutation-related cognitive dysfunction were obtained respectively by microarray data analysis, the common differential genes were obtained by intersection between the two diseases. GO analysis, KEGG and Reactome pathway analysis were performed on the selected differential genes. The protein-protein interaction(PPI) network was constructed using online database. Finally, the effects of diabetes and TREM2 on spatial learning and memory of mice were detected by water maze, and the expression of hub gene SNAP25 was detected by Western blot. Results In both datasets, 19 genes showed similar changes, mainly enriched in biological processes and pathways related to neurons and metabolism. According to PPI analysis, DNER, GFAP, GRM5 and SNAP25 were identified as hub genes. Trem2 gene knockout aggravated spatial learning and memory impairment in diabetic mice. The expression of SNAP25 in hippocampus of diabetes mice was significantly increased, and then decreased after Trem2 knockout. Conclusions This study identified 19 TREM2-related genes in diabetes with cognitive dysfunction, among which 4 hub genes were found. These results provide a new experimental basis for the treatment of diabetes patients with cognitive impairment. [ABSTRACT FROM AUTHOR]

Objective To investigate the impact of adductor canal block combined with general anesthesia on postoperative pain and cognitive function in elderly patients undergoing total knee arthroplasty (TKA). Methods A total of 72 elderly patients undergoing elective TKA were selected and divided into the control group and the observation group with 36 patients in each group using a random number table method. The control group was given simple general intravenous anesthesia, and the observation group received adductor canal block under ultrasound guidance combined with general anesthesia. Both groups of patients were connected to patient-controlled intravenous analgesia (PCIA) pumps after surgery. Data of heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded at the time of entering the operating room (T0), insertion of the laryngeal mask (T1), 30 minutes after the start of surgery (T2) and the end of surgery (T3). Visual analog scale (VAS) pain scores were recorded in the first 48 hours postoperatively. Levels of C-reactive protein (CRP), interleukin-6 (IL-6) and Mini-Mental State Examination (MMSE) scores were recorded 3 days after surgery. Additionally, the dosage of propofol and sufentanil, PCIA press times, awakening time, extubation time, first time out of bed and length of hospital stay were compared between the two groups. Results Compared with the control group, the observation group showed a decrease in HR at T1 and T3, and an increase in SBP and DBP (P＜0.05). In comparison with the control group, the observation group showed lower VAS scores, along with reduced CRP and IL-6 levels, and higher MMSE scores (P＜0.05) at the same postoperative time points. Patients in the observation group showed reduced doses of propofol and sufentanil, fewer PCIA presses, shorter postoperative recovery, extubation, first time out of bed and hospital stay than those of patients in the control group (P＜0.05). Conclusion The application of ultrasound-guided adductor canal block combination with general anesthesia helps alleviate postoperative pain, relieve stress responses and improve cognitive function level in elderly patients with total knee replacement surgery. [ABSTRACT FROM AUTHOR]

Background Postoperative cognitive dysfunction (POCD) is one of the major causes of increased postoperative morbidity and mortality in patients. The inflammatory response and ferroptosis are the principal hypotheses of the mechanism of POCD development. But the mechanism of electroacupuncture to improve learning and memory function in POCD patients is unclear. Objective To observe the effect of electroacupuncture on learning, memory, inflammatory cytokines and ferroptosis of hippocampal neurons in aged rats with POCD, so as to explore the mechanism of improving POCD by electroacupuncture. Methods From January 2022 to February 2023, 72 SD rats aged 18 to 20 months were selected and divided into 3 groups according to random number table method of control group (n=24) , model group (n=24) and electroacupuncture group (n=24) . According to the observation time points of 3 and 7 days postoperative, the rats in each group were divided into 2 the subgroups (3 d postoperative subgroup in control group, 7 d postoperative subgroup in control group, 3 d postoperative subgroup in model group, 7 d postoperative subgroup in model group, 3 d postoperative subgroup in electroacupuncture group, 7 d postoperative subgroup in electroacupuncture group) , with 12 rats in each group. POCD model was established by exploratory laparotomy, and Baihui and Neiguan points were stimulated by electroacupuncture. The Morris water maze device was used to detect the behavioral performance of rats. The contents of interleukin (IL) 6, IL-10, tumor necrosis factor alpha (TNF-α) in serum and hippocampus were detected by enzyme-linked immunosorbent assay, and lipid peroxides (LPO) and Fe2+ in hippocampus were detected. The protein expression levels of acyl coenzyme A synthetase long-chain family member 4 (ACSL4) , ferritin heavy chain 1 (FTH1) and lysophosphatidylcholine acyltransferase-3 (LPCAT3) in hippocampus were detected by Western Blotting. The ultrastructure of hippocampal neurons was observed by transmission electron microscopy. Results Group and time had no interaction effect on the escape latency of cognitive function training at 3 and 7 d postoperatively (Pinteraction>0.05) , the main effect of training time on the escape latency of cognitive function training was significant (Ptime0.05) . The escape latency of 3 d postoperative subgroup in model group was higher than that of 3 d postoperative subgroup in control group and 3 d postoperative subgroup in electroacupuncture group. The frequency of crossing platform and target quadrant residence time of 3 d postoperative subgroup in model group were lower than those of 3 d postoperative subgroup in control group and 3 d postoperative subgroup in electroacupuncture group; the frequency of crossing platform in 3 d postoperative subgroup in electroacupuncture group was lower than that of 3 d postoperative subgroup in control group (P

Objective: To observe the effect of Fufang Huonaoshu capsule combined with Donepezil on cognitive function and serum brain neurotransmitters in patients with Parkinson's disease (PD) with mild cognitive impairment (PD-MCI). Methods: 128 patients with PD-MCI who received treatment in our hospital from March 2021 to December 2022 were selected. The patients were divided into a control group (treated with Donepezil) and a study group (treated with compound Huonaoshu capsule and Donepezil) according to the method of random number table, with 64 cases in each group. The efficacy, the Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the Activity of Daily Living Scale (ADL) and serum brain neurotransmitters [5-HT, Acetylcholine, dopamine] were compared between the two groups. Simultaneously observe the incidence of adverse reactions during treatment in both groups. Results: Compared with the control group, the clinical total effective rate of the study group was significantly increased (P<0.05). After 12 weeks of treatment, the MMSE, MoCA, and ADL scores of the study group were higher than those of the control group (P<0. 05). After 12 weeks of treatment, the 5-HT, Ach, and DA levels in the study group were higher than those in the control group (P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Fufang Huonaoshu capsule combined with Donepezil can effectively improve the cognitive function of patients with PD-MCI, improve the serum brain neurotransmitter level, and improve the daily living ability of patients. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the role of protective function of Sestrin2 (Sesn2) to mitochondria in alleviating cognitive dysfunction in mice with sepsis-associated encephalopathy (SAE). Methods 6-week-old male C57BL/6J mice were randomly divided into three groups: sham group, CLP group and CLP plus eupatilin group, 40 mice in each group. A sepsis model was induced by cecal ligation and perforation (CLP). The CLP plus eupatilin group was treated with eupatilin. Neurobehavioral test and Morris water maze (MWM) were used to determine neurobehavior and spatial learning and memory function in mice. The number of neurons in hippocampal CA1 area was counted by Nissl staining. HT22 cells were randomly divided into a control group (Con), lipopolysaccharide group (LPS), LPS plus eupatilin treatment group (LPS plus eupatilin) and LPS plus eupatilin and Nrf2 siRNA treatment group (LPS plus eupatilin and si-Nrf2). Apoptosis was analyzed by terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) staining, Mitochondrial membrane potential (MMP) was used to analyze mitochondrial damage. Results Seven days after CLP, as compared with sham mice, Sesn2 in hippocampus and cortex decreased significantly in CLP mice (P < 0.01). As compared with CLP group, the survival rate in CLP plus eupatilin group increased significantly (P < 0.05). As compared with sham group, the mice in CLP group showed a relatively high nerve injury score (P < 0.05), and had fewer platform crossings and shorter target stay time, while the mice in CLP plus eupatilin group exhibited a lower injury score (P < 0.05), and stayed in the target area for a longer time (P < 0.05). As compared with sham group, the co-localization rate of neurons, Sesn2 and Nrf2 in CLP group decreased significantly (P < 0.05), and the number of CD68/Iba-1 positive microglia increased significantly (P < 0.05), while CLP plus eupatilin group reversed these changes. As compared with Con group, apoptosis and MMP level in LPS group increased significantly (P < 0.01), while apoptosis and MMP level in LPS plus eupatilin group were lower than those in LPS group (P < 0.05). However, Nrf2 knockdown (LPS plus eupatilin and si-Nrf2 group) reversed the anti-apoptosis and mitochondrial protection of eupatilin. Conclusions Eupatilin can alleviate cognitive dysfunction and neurological deficit in SAE mice by activating Sesn2-Nrf2 pathway, and improve inflammatory microenvironment by alleviating mitochondrial dysfunction. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between factors related to the transforming growth factor β ( TGF-β) /Aerine-threonine kinase receptors ( Smads) signaling pathway and cognitive dysfunction in peripheral blood of patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods The clinical data of 100 patients with aSAH admitted to Chongzuo City People's Hospital from October 2018 to March 2022 were retrospectively selected and grouped according to the patients' Montreal Cognitive Assessment Scale (MoCA) scores, including 54 cases with cognitive dysfunction and 46 cases without cognitive dysfunction. The clinical data, peripheral blood TGF-β, Smad1, Smad3, and Smad7 mRNA expression levels of the two groups were compared. The relationship between pathway-related factors and cognitive dysfunction in patients with aSAH was analyzed in a multifactorial manner. The predictive value of pathway-related factors for cognitive dysfunction in aSAH patients was assessed using the receiver operating characteristic (ROC) curve. Results Peripheral blood TGF-β, Smad1, Smad3, and Smad7 mRNA expression levels were higher in the cognitively impaired group than in the group without cognitive impairment (P < 0.05). Multifactorial showed that pathway-related factors were significantly associated with cognitive impairment in patients with aSAH (P < 0.05). The ROC showed that the area under the curve (AUC) of pathway-related factors jointly predicted cognitive dysfunction in patients with aSAH was superior to that predicted alone (P<0.05). Conclusion The high expression of factors related to the TGF-β/Smads signaling pathway in the peripheral blood of aSAH patients suggests that this pathway may be associated with cognitive dysfunction in patients. [ABSTRACT FROM AUTHOR]

Objective To analyze the influence of intraoperative blood glucose fluctuation and postoperative insulin resistance (IR) on postoperative cognitive dyfunction (POCD) in elderly patients undergoing thoracoscopic radical resection of lung cancer under general anesthesia. Methods A total of 352 elderly patients undergoing thoracoscopic radical resection of lung cancer under general anesthesia were collected and divided into the POCD group (n=84) and the nonPOCD group (n=268). The covariates between the two groups were balanced by propensity score matching method (PSM). Eighty-four cases in each group were successfully matched. The data between the two groups before and after PSM were compared. After PSM, receiver operating characteristic (ROC) curve of blood glucose fluctuation amplitude for predicting POCD was drawn, and patients were divided into the low-level blood glucose fluctuation group (n=97) and the high-level blood glucose fluctuation group (n=71) according to the cut-off value. According to the existence of postoperative IR, patients were divided into the IR group (n=53) and the non-IR group (n=115). Then, incidences of POCD between groups were compared. Logistic regression was used to analyze the influencing factors of POCD. Results Before PSM, the POCD group had older age, higher blood glucose fluctuation amplitude, IR ratio, operation time, anesthesia time, propofol dosage, remifentanil dosage and sufentanil dosage in anesthesia maintenance period than those in the non-POCD group (P＜0.05). The POCD group had higher blood glucose fluctuation amplitude and IR ratio than those in the non-POCD group after PSM (P＜0.05). After PSM, the incidences of POCD in the high-level blood glucose fluctuation group and the IR group were higher than those in the low-level blood glucose fluctuation group and the non-IR group (P＜0.05). Logistic regression analysis showed that higher intraoperative blood glucose fluctuation (OR=9.140, 95%CI: 4.338-19.257) and postoperative IR (OR=4.034, 95%CI: 1.163-13.991) were risk factors of POCD. Conclusion The risk of POCD in elderly patients undergoing thoracoscopic radical lung cancer surgery under general anesthesia is increased in patients with higher intraoperative blood glucose fluctuation and postoperative IR. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background The effects of childhood experiences on the health of middle-aged and older adults has become a research hotspot. However, the effects and pathways of childhood experiences on cognitive function in middle-aged and older adults still remain unclear. Objective To analyze the effect of childhood socioeconomic status on cognitive function in middle-aged and older adults from a whole life cycle perspective, and explore promotion strategies for cognitive function in middle-aged and older adults. Methods The China Family Panel Studies (CFPS) for 2010, 2012, and 2020 was used to construct a multiple mediated-effects model to investigate the mediating pathways of the effect of childhood socioeconomic status on cognitive function in middle-aged and older adults. Pearson correlation analysis was used to analyze the relationship between various indicators. Results A total of 1 034 middle-aged and older adults with an average age of (62.33±9.89) years were included in this study. The childhood socioeconomic status score was (0.000±0.797), education level score was (1.970±1.111), social participation score was (1.150±0.967), depression status score was (5.960±4.681), and cognitive score was (0.000±1.000). Childhood socioeconomic status was positively correlated with education level, social participation, and cognitive function in middle-aged and older adults (P

Background Cognitive impairment can lead to a decline in cognitive function, depression, and loneliness, as well as decreased self-efficacy and quality of life in older adults. Objective To investigate the effects of non-pharmacological integrated interventions on cognitive function, depression, loneliness, self-efficacy, and quality of life in older adults with mild cognitive impairment. Methods Based on risk factors for cognitive impairment, a non-pharmacological integrated intervention program was developed in five dimensions of cognitive training, physical exercise, emotional management, social connection, and healthy lifestyle habits. Using a single-subject A-B-A experimental design, a 3-month intervention, which was conducted once a week for 60 minutes, was performed in three elderly individuals with mild cognitive impairment from June to December 2021. The Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale-15 (GDS-15), 12-item Short Form Health Survey (SF-12), General Self-Efficacy Scale (GSES), and De Jong Gierveld Loneliness Scale (DJGLS) were administered to the 3 older adults at baseline, 3 months of the intervention, and 3 months after the intervention, to assess the scores of each scale from the 5 dimensions of cognitive function, self-efficacy, quality of life, depression, and loneliness, the changes in the scores were analyzed. A semi-structured interview was conducted 3 months after the intervention to evaluate the intervention effects in terms of cognitive function, quality of life, depression, self-efficacy, and loneliness dimensions. Results The 3 older adults included in the study were 74, 70, 73 years old, all married, living with their spouses and grandchildren. The three older adults had MoCA scores of 21, 22, and 24 at baseline, 28, 26, and 27 at 3 months of intervention, and 25, 19, and 23 at 3 months after intervention; GSES scores were 25, 30, and 27 at baseline, 29, 29, and 30 at 3 months of intervention, and 28, 31, and 28 at 3 months after intervention. SF-12 scores were 69, 32, and 51 at baseline, 81, 81, and 83 at 3 months of intervention, and 78, 38, and 59 at 3 months after intervention. The GDS-15 scale scores were 4, 8, and 2 at baseline, 2, 6, and 1 at 3 months of intervention, and 1, 8, and 4 at 3 months after intervention. The DJGLS scores were 8, 7, and 8 at baseline, 5, 5, and 4 at 3 months of intervention, and 5, 5, and 7 at 3 months after intervention. Semi-structured interview data indicated improvement in all five dimensions of cognitive function, quality of life, depression, loneliness, and self-efficacy of the subjects. Conclusion For older adults with mild cognitive impairment, it is of great significance to perform a non-pharmacological integrated intervention in terms of cognitive training, physical exercise, emotional management, social connection, and healthy lifestyle habits. The MoCA, SF-12, GDS-15, and DJGLS scores of older adults with mild cognitive impairment improved at 3 months of intervention, while the GSES scores improved at 3 months after intervention. GSES scores were not as effective after the intervention. All dimension scores showed a decreasing trend at 3 months after the intervention.

Recent studies have identified a trend toward cognitive decline and even progression to dementia in patients with metabolic syndrome (MetS), and Alzheimer's disease (AD) is the most important subtype of dementia. In reviewing the correlation between cognitive impairment due to MetS and development of AD in previous studies, this paper highlights the growing body of data that supports MetS as a whole as well as its components of hypertension and hyperglycemia as risk factors for AD, whereas insulin resistance, neurologic chronic inflammation, and adipokine disorders play important roles in the pathogenesis. Since there are now no viable treatment alternatives available to stop or reverse the degenerative progression of AD, it is expected to provide scientific evidence for a comprehensive strategy for early prevention and treatment of AD by targeting relatively curable MetS for intervention.

As a common neurological disease, cognitive impairment is characterized by cognitive decline, memory and attention impairment, which seriously affects the patients' quality of life. The etiology and pathogenesis of cognitive impairment are complex and diverse. Studies have shown that chronic persistent neuroinflammation plays a key role in its development. Microglia and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome are closely related to neuroinflammation and cognitive impairment. Regulation of microglia and NLRP3 inflammasome can reduce inflammatory factors, reduce amyloid β-protein(Aβ) deposition, regulate autophagy, maintain synaptic homeostasis, thus reducing neuroinflammation and further preventing and treating cognitive impairment. Therefore, exploring the mechanism of microglia and NLRP3 inflammasome as well as their interaction in cognitive impairment can provide some reference and basis for the in-depth study of the mechanism and clinical prevention and treatment of cognitive impairment, and the subsequent development of more efficient drugs.

There are many types of assessment tools for dementia patients both domestically and internationally. However, assessments using single-dimensional measurement tools often have limitations, and there is still a lack of reports on comprehensive assessment tools specifically for dementia patients in current. Based on this, the comprehensive assessment tools for the elderly with dementia are reviewed both domestically and internationally, 8 assessment tools from the perspectives of demand and function for the elderly with dementia are summarized, and the content, reliability and validity, application of each tool are discussed in this paper, in order to provide reference for the use and development of assessment tools for the elderly with dementia in China.

Objective·To investigate the causal relationship between atrial fibrillation (AF) and cognitive impairment.Methods·A two-sample Mendelian randomization (TSMR) analysis was used to assess the potential causality of AF on cognitive dysfunction. Single nucleotide polymorphisms (SNPs) strongly associated with AF were extracted as instrumental variables by using a dataset of a large-scale genome-wide association study (GWAS) on AF. The associations of SNPs with Alzheimer′s disease dementia, Parkinson′s disease dementia, vascular dementia, Lewy body dementia, frontotemporal dementia, undefined dementia, and overall cognitive function assessment were extracted separately from publicly available GWAS data on cognitive dysfunction. The inverse variance-weighted (IVW) method was used for the main analysis, and sensitivity analyses were conducted by using Cochran′s Q test, MR-Egger regression, and leave-one-out method. To verify the robustness of the results, replicate analyses and meta-analyses were performed by using different GWAS data.Results·In the initial analysis, 101 SNPs were extracted as instrumental variables from a meta-analysis of a genome-wide association study involving up to 1 030 836 individuals. The IVW analysis showed no evidence for causal associations between AF and dementia [dementia (OR=1.032; 95%CI 0.973‒1.094; P=0.290), Parkinson′s disease dementia (OR=1.004; 95%CI 0.780‒1.291; P=0.977), vascular dementia (OR=1.123; 95%CI 0.969‒1.301; P=0.125), or unspecified dementia (OR=1.013; 95%CI 0.910‒1.129; P=0.807)]. In the replication analysis, 27 SNPs were extracted as instrumental variables from the FinnGen AF GWAS data, and the IVW analysis were consistent with the initial analysis [cognitive function (OR=0.999; 95%CI 0.982‒1.016; P=0.874), Alzheimer′s disease dementia (OR=0.977; 95%CI 0.943‒1.012; P=0.193), Lewy body dementia (OR=1.014; 95%CI 0.898‒1.145; P=0.826), or frontotemporal dementia (OR=0.996; 95%CI 0.745‒1.333; P=0.980)]. Both Mendelian randomization analyses and meta-analyses showed no evidence of an association between genetically predicted AF and different types of dementia or overall cognitive function assessment. MR-Egger regression suggested no horizontal pleiotropy and leave-one-out analysis showed stable results after individually removing each SNP.Conclusion·No evidence of a causal relationship between AF and cognitive impairment was found. The associations observed in observational studies can be partially attributed to confounding factors such as shared biology or co-morbidities.

Objective To investigate whether salvianolic acid B (Sal B) can improve the cognitive function in rats with post-traumatic stress disorder (PTSD) by regulating GSK-3β/β -Catenin signal pathway. Methods Sixty rats were randomly grouped into the normal group, the PTSD group, the Sal B low-dose group (10 mg/kg), the Sal B high-dose group (20 mg/kg) and the GSK-3β inhibitor group (30 mg/kg CHIR-99021), with 12 rats in each group. In addition to the normal group, rats in other groups were constructed PTSD rat models by using single prolonged stress (SPS) method. Open field test and Morris water maze test were applied to evaluate the cognitive function of rats. Nissl staining was applied to observe the pathological changes of hippocampal neurons. TUNEL staining was applied to detect the apoptosis of hippocampal neurons. Western blot assay was applied to detect the expression of cleared caspase-3, B-cell lymphoma gene-2-associated X protein (Bax), proto-oncogene (c-Myc), Cyclin D1, total GSK-3β (t-GSK-3β), phosphorylated GSK-3β (p-GSK-3β), total β-Catenin (t-β-Catenin) and phosphorylated β-catenin (p-β-Catenin) proteins in hippocampus. Results Compared with the PTSD group, the number of crawling spaces, standing times, total movement distance and times of crossing the original platform of rats were higher in the Sal B low-dose group, the Sal B high-dose group and the GSK-3β inhibitor group. The escape latency and the time to cross the original platform for the first time were shorter, the apoptosis rate of hippocampal neurons and the expression levels of Bax, cleaved caspase-3, t-GSK-3β and p-β-Catenin proteins in hippocampus were lower, and the expression levels of Cyclin D1, c-Myc, p-GSK-3β, t- β -Catenin proteins were higher (P＜0.05). Conclusion Sal B can reduce the apoptosis and damage of hippocampal neurons in rats with PTSD and improve cognitive dysfunction in rats, and inhibit the GSK-3β/β-Catenin signal pathway. [ABSTRACT FROM AUTHOR]

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the influence of miR-139-5p on cognitive dysfunction in chronic cerebral hypoperfusion (CCH) rats by targeting receptor-interacting protein kinase-1 (RIPK1)/receptor-interacting protein kinase-3 (RIPK3)/mixed lineage kinase domain-like protein (MLKL) signal pathway. Methods Sixty SPF SD rats were randomly divided into the sham operation group, the model group, the miR-NC group, the miR-139-5p mimic group and the miR139-5p mimic+RIPK1 inhibitor Nec-1 group (miR-139-5p mimic+Nec-1 group), with 12 rats in each group. Except the sham group, the other groups used permanent ligation of bilateral common carotid arteries to construct rat CCH model. New object recognition experiment and Morris water maze were used to evaluate the cognitive function of rats. Enzyme linked immunosorbent assay (ELISA) was used to detect levels of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), malondialdehyde (MDA), inflammatory factor tumor necrosis factor (TNF)-α and interleukin-6 (IL-6) in rat hippocampus. Real-time quantitative PCR (qPCR) was used to detect the expression of miR-139-5p, RIPK1, RIPK3, MLKL mRNA in rat hippocampus. Western blot method was used to detect the protein expression levels of RIPK1, RIPK3, MLKL, synaptophysin (SYP), postsynaptic density protein 95 (PSD95) and α-synuclein (α-SYN). Double luciferase reporter gene experiment was used to verify the relationship between miR-139-5p and RIPK1. Results Compared with the sham group, the resolution coefficient, target quadrant residence time, levels of miR-139-5p, GSH-Px, SOD and the protein expression levels of SYP and PSD95 decreased obviously in hippocampus of the model group rats (P＜0.05). The escape latency extended, and levels of MDA, TNF-α and IL-6 in hippocampus increased. The mRNA and protein expression of RIPK1, RIPK2, MLKL, the protein expression of α-SYN increased obviously (P＜0.05). Compared with the model group and the miR-NC group, the expression trends of related indexes were opposite to the above in the miR-139-5p mimic group (P＜0.05). Nec-1 further promoted the recovery of cognitive function in CCH rats by up-regulating the expression of miR-139-5p (P＜0.05). MiR139-5p negatively regulated the expression of RIPK1. Conclusion The up regulation of miR-139-5p may alleviate the cognitive dysfunction of CCH rats by targeting the inhibition of RIPK1/RIPK3/MLKL signaling pathway. [ABSTRACT FROM AUTHOR]

Objective. To investigate the causal relationship between atrial fibrillation (AF) and cognitive impairment. Methods. A two-sample Mendelian randomization (TSMR) analysis was used to assess the potential causality of AF on cognitive dysfunction. Single nucleotide polymorphisms (SNPs) strongly associated with AF were extracted as instrumental variables by using a dataset of a large-scale genome-wide association study (GWAS) on AF. The associations of SNPs with Alzheimer′s disease dementia, Parkinson′s disease dementia, vascular dementia, Lewy body dementia, frontotemporal dementia, undefined dementia, and overall cognitive function assessment were extracted separately from publicly available GWAS data on cognitive dysfunction. The inverse variance-weighted (IVW) method was used for the main analysis, and sensitivity analyses were conducted by using Cochran′s Q test, MR-Egger regression, and leave-one-out method. To verify the robustness of the results, replicate analyses and meta-analyses were performed by using different GWAS data. Results. In the initial analysis, 101 SNPs were extracted as instrumental variables from a meta-analysis of a genome-wide association study involving up to 1 030 836 individuals. The IVW analysis showed no evidence for causal associations between AF and dementia [dementia (OR=1.032; 95%CI 0.973 ‒ 1.094; P= 0.290), Parkinson′s disease dementia (OR=1.004; 95%CI 0.780 ‒ 1.291; P=0.977), vascular dementia (OR=1.123; 95%CI 0.9691.301; P=0.125), or unspecified dementia (OR=1.013; 95%CI 0.910‒1.129; P=0.807)]. In the replication analysis, 27 SNPs were extracted as instrumental variables from the FinnGen AF GWAS data, and the IVW analysis were consistent with the initial analysis [cognitive function (OR=0.999; 95%CI 0.982‒1.016; P=0.874), Alzheimer′s disease dementia (OR=0.977; 95%CI 0.943‒1.012; P= 0.193), Lewy body dementia (OR=1.014; 95%CI 0.898‒1.145; P=0.826), or frontotemporal dementia (OR=0.996; 95%CI 0.745‒ 1.333; P=0.980)]. Both Mendelian randomization analyses and meta-analyses showed no evidence of an association between genetically predicted AF and different types of dementia or overall cognitive function assessment. MR-Egger regression suggested no horizontal pleiotropy and leave-one-out analysis showed stable results after individually removing each SNP. Conclusion. No evidence of a causal relationship between AF and cognitive impairment was found. The associations observed in observational studies can be partially attributed to confounding factors such as shared biology or co-morbidities. [ABSTRACT FROM AUTHOR]

Objective To investigate the expression levels of serum exosomal miR-223 and nucleotide-binding oligome-rization domain-like receptor protein 3 (NLRP3) in patients with Alzheimer’s disease (AD) and their association with the development and progression of AD. Methods A total of 65 elderly patients with AD who attended Department of Geriatrics in our hospital from March 2018 to December 2019 were enrolled as study group and were divided into mild cognitive impairment (MCI) subgroup with 41 patients and dementia of Alzheimer type (DAT) subgroup with 24 patients, and 60 elderly individuals with normal neurological function were enrolled as control group. Quantitative real-time PCR and ELISA were used to measure the expression levels of serum exosomal miR-223 and NLRP3. The Pearson and Spearman tests were used to analyze the correlation of serum exosomal miR-223 and NLRP3 with Mini-Mental State Examination (MMSE) score. The receiver operating characteristic (ROC) curve was plotted to calculate the area under the ROC curve (AUC) of serum exosomal miR-223 and NLRP3 in the diagnosis of MCI in AD patients or the differential diagnosis of DAT. Results Compared with the control group, the study group had a significantly lower expression level of serum exosomal miR-223 and a significantly higher expression level of NLRP3 (t=6.623,Z=-9.451,P

Background Intellectual activities such as reading and playing puzzle games can slow the decline of cognitive function in the elderly, but the effects of specific types of such activities on cognitive function and cognitive domains need to be further studied. Objective To explore the influence of common types of intellectual activities on cognitive function and cognitive domains of the elderly in the community. Methods From May to August 2022, stratified convenience sampling was used to select elderly people from four communities in Nanjing, Changzhou, Nantong and Xuzhou of Jiangsu Province. A face-to-face survey was conducted with a general information questionnaire and the Montreal Cognitive Assessment (MoCA) Beijing edition to collect data regarding sociodemographics, frequency and types of intellectual activities, and cognitive function. Stepwise multiple regression analysis was used to explore the relationship between intellectual activities and different cognitive domains. Results In total, 782 cases attended the survey, and 758 of them (96.93%) who completed it were included for analysis, including123 from Nanjing, 197 from Changzhou, 240 from Nantong, and 198 from Xuzhou. The intellectual activities done by these older people include learning new knowledge (n=170), playing chess and cards (n=228), reading (n=228), singing (n=59), playing puzzle games (n=57), helping grand children with their homework (n=42), painting (n=16), playing a musical instrument (n=47), and practicing calligraphy (n=30). Stepwise multiple linear regression analysis showed that learning new knowledge, reading, helping grand children with their homework, playing puzzle games and playing musical instruments were associated with cognitive function (P

Background With the accelerated aging process, the incidence of dementia is increasing year by year, but there is no effective cure and the prognosis is poor. The cognitive function is still plastic during subjective cognitive decline (SCD) , which as a preclinical stage of dementia, it is of great significance for the prevention and management of dementia to investigate the prevalence and influencing factors of SCD. Objective To investigate the prevalence and risk factors of SCD, MCI and dementia in population aged 60 and above in Baotou, Inner Mongolia. Methods From June 2021 to September 2022, a cross-sectional survey was conducted involving 1 120 objects in 21 neighborhood councils and 17 village committees randomly selected from 3 banner counties (Hondlon District, Jiuyuan District and Guyang County) of Baotou City, Inner Mongolia Autonomous Region by using the combination of multistage sampling, cluster sampling and random sampling. General information of the study subjects were collected by questionnaire and their cognitive function was assessed. According to cognitive function, the study subjects were divided into the normal group (n=206) , SCD group (n=491) , MCI group (n=320) and dementia group (n=103) . Multivariate Logistic regression was used to analyze the influencing factors of cognitive function. Results The median age of the study subjects was 68.0 (63.0, 73.0) years and the median number of years of education was 9.0 (5.0, 11.4) years. Absence of spouse〔OR=2.542, 95%CI (1.139, 5.674) , P=0.023〕, obesity〔OR=6.058, 95%CI (2.281, 16.093) , P

Cognitive dysfunction refers to the functional impairment in one or more cognitive domains, mostly occurs in older adults. Cognitive dysfunction can commonly be divided into subjective cognitive decline (SCD), mild cognitive impairment (MCI) and dementia, depending on the degree of cognitive impairment. People with SCD or MCI have a higher risk of dementia, which seriously affects their quality of life, and imposes a huge burden on families and society. Numerous studies have demonstrated that physical activity is one effective non-pharmacological intervention for cognitive dysfunction, but there are no uniform standards for physical activity programs for cognitive dysfunction worldwide, and China still has no physical activity guidelines based on the values and preferences of older adults with cognitive dysfunction, partially impeding the dissemination and application of relevant evidence. In view of this, we developed a guideline containing eight recommendations that is applicable in China, namely the Clinical Practice Guideline on Non-pharmacological Interventions for Older Adults with Cognitive Dysfunction: Physical Activity, by the use of existing evidence, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework combined with values and preferences of Chinese older adults with cognitive dysfunction. This guideline will contribute to the reduction of the incidence of cognitive dysfunction, and preventing or slowing the progression of cognitive dysfunction to dementia.

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Objective To investigate the effect of butylphthalide on cognitive dysfunction after the stroke caused by cerebral small vessel disease and its effect on cerebral blood perfusion. Methods　84 patients with the cognitive impairment after the stroke caused by small vessel disease were retrospectively selected from the Neurology Department of Shijiazhuang People’s Hospital from March 2019 to March 2021. According to the different treatment methods, they were divided into the control group (basic treatment) and the study group (basic treatment+butylphthalide treatment), with 42 patients in each group. Cognitive function, daily living ability, neurological function deficits, and changes in cerebral blood flow perfusion were observed. Results After 3 months of treatment，MMSE and Barthel index scores increased and NIHSS scores decreased in the two groups (P < 0.05). After the treatment，MMSE and Barthel index scores in the study group were higher than those in the control group (P < 0.05). The mean passage time of patients in the two groups decreased，and the CEREBRAL blood flow and blood flow velocity increased. In comparison with the results between the two groups，the mean passage time of patients in the study group was lower than that of the control group after the treatment，while the cerebral blood flow and blood flow velocity were significantly higher than that of the control group (P < 0.05). Conclusion Butylphthalide can improve the cerebral blood flow perfusion and promote the recovery of patients’ cognitive function and daily living ability in the treatment of cognitive dysfunction after the stroke caused by cerebral small vascular disease. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of curcumin (Cur) regulating N-methyl-D-aspartate receptor (NMDAR)/calcium ion (Ca2+ )/calmodulin dependent protein kinase Ⅱ (CaMKⅡ) signaling pathway on isoflurane (ISO) - induced postoperative cognitive dysfunction (POCD) in young mice. Methods Seventy-two C57BL/6J mice were separated into the control group, the ISO group, the low-dose Cur group (Cur-L group, 50 mg/kg), the medium-dose Cur group (Cur-M group, 100 mg/kg), the high-dose Cur group (Cur-H group, 200 mg/kg) and the Cur-H+NMDA (NMDAR activator) group (200 mg/kg+8 mg/kg), with 12 animals in each group. After 30 min of corresponding drug treatment, the mice in the control group inhaled a mixed gas containing 30% oxygen and air for 2 hours, and mice in the other groups inhaled 2% ISO for 2 hours, once a day for 14 days. Twenty-four hours after the last treatment, Morris water maze test was used to detect the learning and spatial memory abilities of mice. HE staining was used to detect the pathological changes in hippocampal CA1 area. Immunofluorescence staining was used to detect the positive expression of neuron specific nucleoprotein (NeuN) in hippocampus CA1 region of mice. TUNEL staining was used to detect neuronal apoptosis. Enzyme linked immunosorbent assay was used to detect levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in hippocampal CA1 tissue. Western blot assay was used to detect NMDAR1 and CaMK Ⅱ protein expression in mouse hippocampal CA1 tissue. Intracellular Ca2+ concentration in hippocampal CA1 region was detected by fluorescence probe. Results Compared with the control group, the pathological damage of hippocampal CA1 region of mice was severe in the ISO group, and the escape latency was prolonged. The apoptosis rate of neural cells, levels of IL-1β and TNF-α, expression levels of NMDAR1 and CaMKⅡ protein, and the concentration of Ca2+ in hippocampal CA1 region were increased (P＜0.05). Times of crossing platform and the number of NeuN positive cells were decreased in the ISO group (P＜0.05). Compared with the ISO group, pathological damages of hippocampal CA1 region of mice were alleviated in the Cur-L group, the Cur-M group and the CurH group, the escape latency was shortened, and the apoptosis rate of neural cells, levels of IL-1β and TNF-α, expression levels of NMDAR1 and CaMKⅡ protein, and the concentration of Ca2+ in hippocampal CA1 region were decreased (P＜ 0.05). Times of crossing platform and the number of NeuN positive cells were increased (P＜0.05), which was dosedependent. NMDA attenuated the improvement effect of high-dose Cur on ISO induced POCD in mice (P＜0.05). Conclusion Curcumin may improve ISO-induced POCD in mice by inhibiting NMDAR/Ca2+ /CaMKⅡ signaling pathway [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between serum osteopontin (OPN), vascular endothelial growth factor (VEGF), homocysteine (Hcy) and renal function and cognitive dysfunction (CD) in elderly patients with type 2 diabetic kidney disease (T2DKD). Methods: 140 patients with T2DKD who were admitted to the Second Affiliated Hospital of Anhui Medical University from January 2017 to June 2022 were selected as T2DKD group. According to the occurrence of CD, they were divided into CD group with 41 cases and non-CD group with 99 cases, 60 patients with simple T2DM were selected as T2DM group, and 50 healthy volunteers during the same period were selected as control group. Serum OPN, VEGF, Hcy were measured and renal function indexes[urinary albumin/creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR)] were calculated. Spearman correlation was used to analyze the correlation between serum OPN, VEGF, Hcy levels and renal function indexes in elderly patients with T2DKD, and multivariate Logistic regression was used to analyze the influencing factors of CD in elderly patients with T2DKD. Results: Serum OPN, VEGF, Hcy levels and UACR in the control group, T2DM group and T2DKD group were increased successively, while eGFR was decreased successively(P＜0.05). Spearman correlation analysis showed that serum OPN, VEGF and Hcy levels in elderly patients with T2DKD were positively correlated with UACR, and negatively correlated with eGFR(P＜0.05). Multivariate Logistic regression analysis showed that homeostasis model assessment-insulin resistance (HOMA-IR), OPN, VEGF and Hcy were elevated as independent risk factors for CD in elderly patients with T2DKD, and eGFR was elevated as an independent protective factor(P<0.05). Conclusion: Elevated serum OPN, VEGF and Hcy levels in elderly patients with T2DKD are closely related to renal function and CD, and which may be an auxiliary predictor of CD in elderly patients with T2DKD. [ABSTRACT FROM AUTHOR]

Background With the rapid population aging in China, cognitive impairment in older adults has become a growing public health concern. Objective To examine the association between nighttime sleep duration and cognitive impairment among community-dwelling older adults. Methods Data were derived from the cohort of Older Adult Health and Modifiable Environmental Factors established in Fuyang City from July to September 2018, among whom a total of 4 837 older adults with complete data on cognitive function and sleep time were included in this study. General demographic characteristics〔gender, age, living area (urban or rural), education level, occupation, marital status〕, living habits, the history of chronic diseases, sleep duration, and overall cognitive function were extracted. Binary Logistic regression models were used to analyze the association between nighttime sleep duration and cognitive impairment. Restrictive cubic splines were used to further determine potential dose-response relationships between them. Results The participants had a mean nighttime sleep duration of (6.95±1.75) hours, among whom 1 773 (36.65%) slept ≤6 hours per day, 2 088 (43.17%) slept >6-8 hours per day, and 976 (20.18%) slept >8 hours per day. The detection rate of cognitive impairment was 37.44% (1 811/4 837). After adjusting for gender, age, living area, education level and other confounding factors, the detection rate of cognitive impairment was 1.26〔95%CI (1.09, 1.46) 〕 times higher in older adults with nighttime sleep duration of ≤6 hours, and was 1.22〔95%CI (1.03, 1.46) 〕 times higher in older adults with nighttime sleep duration of >8 hours than in those with nighttime sleep duration of >6-8 hours (P8 hours was 1.35〔 (95%CI (1.06, 1.72) 〕 times higher than in those with nighttime sleep duration of >6-8 hours (P6-8 hours (P

Background Hypertension and mild cognitive impairment (MCI) are ordinary health problems in the elderly. The research on the status and risk factors of hypertension complicated with MCI in elderly population in the community is insufficient. Objective To inquire into the prevalence of hypertension combined with MCI in urban communities and analyze the possible influencing factors of its comorbidities. Methods Five communities with a relatively high proportion of elderly population were selected in Yinchuan City and Wuzhong City of Ningxia Hui Autonomous Region by typical sampling from September to November 2011. A health survey was conducted among all community residents aged≥55 years in the communities. 509 patients with hypertension were included, and multivariate Logistic regression was used to analyze the influencing factors of hypertension patients with MCI. The regression coefficient of each influencing factor was used as the weight to calculate individual predictive risk value, and receiver operating characteristic curve (ROC curve) was drawn to evaluate the predictive value of individual predictive risk value for hypertensive patients with MCI. Results The patients were divided into hypertension with MCI group (n=97) and hypertension without MCI group (n=412) according to whether they were combined with MCI. There were statistically significant differences in age distribution, gender, smoking, hypertension grade, depression score, uric acid and albumin between the two groups (P

Objective To investigate the application value of serum amyloid β 1-42 (Aβ1-42) and phosphorylated tau-181 (P-tau-181) in the clinical diagnosis of cognitive dysfunction in cerebral small vessel disease (CSVD). Methods The patients with CSVD admitted to Nanjing Jiangbei Hospital from July 2019 to July 2020 were divided into the cognitive dysfunction group and normal cognitive function group. Aβ1-42 and P-tau-181 level in the serum of CSVD patients were detected by Enzyme linked immunosorbent assay (ELISA) method, and compared between the two groups. The sensitivity and specificity of the above indicators for the diagnosis of CSVD cognitive dysfunction were analyzed by receiver operating characteristic curve. Results Compared with the normal cognitive function group, the levels of Aβ1-42 and P-tau-181 of patients in the cognitive dysfunction group were significantly increased, the differences were statistically significant (P＜0. 05). The sensitivity and specificity of Aβ1-42 for the diagnosis of CSVD cognitive dysfunction were 75. 51%, 73. 47%, respectively. The sensitivity and specificity of P-tau-181 for diagnosing cognitive impairment in CSVD were 72. 09% and 65. 45%, respectively. Conclusion Serum Aβ1-42 and P-tau-181 are associated with cognitive dysfunction in CSVD, and have certain predictive value for the diagnose of cognitive dysfunction in CSVD. [ABSTRACT FROM AUTHOR]

Background Mild cognitive impairment (MCI) is highly prevalent in hypertensive patients, but the current studies on MCI in hypertension mostly focus on the elderly group, while scarcely involve young and middle-aged patients. Objective To investigate the prevalence and associated factors of MCI in young and middle-aged hospitalized patients with hypertension. Methods A convenience sample of 213 young and middle-aged hypertensive inpatients were recruited from a tertiary grade A hospital in Harbin from May to December 2021. The General Demographic Questionnaire, Montreal Cognitive Assessment (MoCA) , and the Type-D Scale-14 (DS14) were used for understanding patients' demographics, cognitive impairment status, and D-type personality prevalence, respectively. Multiple Logistic regression was used to analyze associated factors of MCI. Results The prevalence of MCI was 37.56% (80/213) . Multiple Logistic regression analysis showed that age〔OR=1.073, 95%CI (1.033, 1.115) 〕, education level〔junior college education level: OR=0.278, 95%CI (0.084, 0.920) , smoking history〔OR=2.494, 95%CI (1.146, 5.426) 〕, stage of hypertension〔stage 2: OR=3.442, 95%CI (1.252, 9.468) ; stage 3: OR=3.934, 95%CI (1.518, 10.193) 〕, D-type personality〔OR=2.160, 95%CI (1.015, 4.598) , TG〔OR=1.596, 95%CI (1.125, 2.265) 〕, and HDL-C〔OR=0.185, 95%CI (0.049, 0.707) 〕were influential factors of MCI in hypertension (P